Permanent pacemaker implantation (PPI) is a relevant complication in patients undergoing transcatheter aortic valve replacement (TAVR) despite there being new devices. The current information on the long term impact of this complication remains unclear and recent evidence suggests post-TAVR ventricular pacing (VP) might be associated to higher risk of all-cause mortality and hospitalization for cardiac...
EuroPCR 2023 | TAVR in TAVR Results with Balloon-Expandable Valves
With the expansion of transcatheter aortic valve replacement (TAVR) use in the low-risk population, more patients will need repeat valve replacement in the future, making it paramount to understand the performance of repeat TAVR. Currently, this information is limited. The aim of this study was to analyze the real-world experience of performing a second TAVR...
EuroPCR 2023 | TAVR in Patients with Bicuspid Aortic Valve Stenosis
Bicuspid aortic valve (BAV) stenosis is the most common congenital valve disease, affecting up to 2% of the population. Patients with BAV disease undergoing transcatheter aortic valve replacement (TAVR) account for 0.5%. In this context, TAVR data on BAV stenosis patients has been limited to observational studies on first generation valves that had resulted in...
EuroPCR 2023 | More Evidence in Favor of Renal Denervation
This study included 219 patients with uncontrolled essential hypertension who had received at least two antihypertensive drugs. All of them underwent a renal angiography and were randomized to the renal denervation group or the control group. Denervation was performed using the SyMapCath I catheter and the SYMPIONEER S1 generator/stimulator. Mean patient age was 45 years old, and...
EuroPCR 2023 | iFR vs FFR Guided Revascularization in Left Main De Novo Lesions
Acute coronary syndrome guidelines recommend the use of iFR and FFR guided invasive management for patients with high risk ischemia regardless medical treatment. However, iFR and FFR they are often considered exchangeable. Prior literature has shown there can be a discrepancy of around 20% between these techniques when it comes to revascularization outcomes. Choosing the...
Abbreviated Antiaggregant Treatment in High Bleeding Risk Patients from the MASTER-DAPT (15-Month Followup)
Benefits of abbreviated antiaggregant treatment in high bleeding risk patients. Dual antiplatelet therapy (DAPT), established by different guidelines, reduces the risk of ischemic events at the expense of increased bleeding. This habitual APT strategy cannot be applied to patients at high risk of bleeding, which is why this populations are treated with shorter DAPT schemes...
Drug Coated Balloons: Link between Femoropopliteal Lesion Calcification Grade and Clinical Outcomes
At present, the use of drug coated balloons (DCB) in femoropopliteal territory is more and more frequent. However, when it comes to treating moderate to severe calcification, the evidence is still limited. Using a peripheral artery calcification scoring system (PACSS) has been associated to clinical outcomes after DCB angioplasty for femoropopliteal lesions. The system categorizes...
Is IVUS Useful in Lower Limb PCI?
Peripheral vascular disease is on the rise and peripheral PCI is at present the first choice of treatment for most patients. The use of IVUS in femoropopliteal territory has shown great benefits, especially in left main and complex PCI, reducing mortality and restenosis but, though promising, in lower limb ischemia we have little information as...
Post PCI Angina: Inevitable or Avoidable?
Predictors of post PCI angina Among the complications of ischemic cardiomyopathy stenting, those called chronic, with significant functional and mental compromise, might affect patient quality of life. This can be observed in different scenarios, such as instent restenosis and post PCI angina. This kind of complications is associated with anxiety and depression at long term. ...
BASILICA: a Complex Strategy, Yet Safe
Coronary artery obstruction (CAO) after TAVR is rare, but it entails extremely high mortality (50% or more), especially after valve-in-valve (V-in-V) or when the coronary ostia are is too close to the valve annulus. This is why the BASILICA technique was developed (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction)....